A known technique for the management of chronic intractable pain of the trunk and limbs is the application of pulsed electrical stimulation through nerve structures in the dorsal aspect of the spinal cord. Spinal cord stimulation may be used either as a sole mitigating agent or as an adjunct to other modes of therapy.
The operative procedure involved comprises inserting a flexible electrode into the patient's epidural space, by passing it between two selected vertebrae and then advancing it under fluoroscopic observation until its end reaches the appropriate spinal level. Use is made of an epidural needle to guide the electrode past the bony structure and direct it properly into and along the epidural space.
An epidural lead or electrode is of necessity an elongated, highly flexible object, and difficulty is frequently encountered in advancing the electrode to its desired site. The procedure has the disadvantage that in order to advance the electrode the surgeon's hands must be in the fluroscopic field and hence subject to X-ray exposure. For the surgeon who frequently performs such electrode implant procedures, this involves undesirable repeated exposure to X-rays.